With this in mind, silver is indicated in wounds that 1) are ... Benskin L.A c t i vation of stalled traumatic finger wound with silver polymeric membrane dressings.
Pearls for Practice
What You Need to Know about Silver Dressings Michel Hermans, MD ressing sel ecti on is an important part of a compreh ensive wound care regi m en that involves proper diagnosis, debridement/excision of n ec rosis, restoring circulation, and providing secon d a ry measures, such as of f l oading or com pression.As with any wound care covering, if a silver dressing is determ i n ed most appropri a te, clinicians should consider any contraindicati ons to any of the dressing compounds. Although resistance to silver is rare, some caution may be necessary because silver now is used in many devices. With this in mind, silver is indicated in wounds that 1) are prone to infection 2) occur in patients prone to infection, and 3) infected (and also receiving systemic antibiotic treatment). Relative contraindications include dry wounds — dressings may need moi s tu re for activa ti on / release of s i lver and moistening may be necessary. Silver dressing change frequency is predicated on dressing saturation based on type of wound (exudate level) and dressing absorpti on / reten ti on capac i ty; whether the wound requires (frequent) dre s s i n g changes (repeated debridement/excision of necrosis is needed and/or the patient’s general or “topical” health puts the wound at (serious) risk of infection; expiration of the documented (package insert) efficacy period of silver; development of local and/or clinical signs of infection; the healing process is not progressing, in which case the diagnosis may be revised; and whether surgical intervention/repair may be more likely to succeed than nonsurgical therapy, in which case a silver dressing may be used postoperatively (eg, over grafts). The duration of silver’s activity depends on the type of dressing. No dressing should be used longer than its clinically efficacious bacterial kill period, which must be proven in sound in vitro study. With informed use, silver dressings provide numerous benefits. - OWM
Commentary from Ferris Mfg. Corp. When selecting a dressing containing silver, clinicians’ wound care goals are much the same as when not using a silver dressing: obtain and maintain a clean wound bed, absorb excess exudate, and provide moisture if the wound is dry, while also filling, covering,and protecting the wound.The silver difference is bioburden management. PolyMem® QuadraFoam® formulated silver dressings are the only dressings that provide all the benefits sought by clinicians in a dressing while also providing antimicrobial action. These dressings have been found to be the most absorptive silver-containing dressing type tested independently.1 This same university-based research team determined that QuadraFoam silver dressings are the least damaging to the healing tissues because the silver is locked up in the dressing where it creates a bacterial kill zone in the dressing rather than in the wound, “thus avoiding ‘collateral damage’ to the healthy tissues in the wound.”1 The researchers found that all the other silver-containing dressings they tested (available in the US) caused severe damage to both keratinocytes and fibroblasts.1 PolyMem Silver QuadraFoam dressings have been used to help jump-start stalled wounds,2 manage wounds in patients prone to infection,3 and help manage infected wounds4 when the underlying cause of the infection was being addressed. QuadraFoam dressings contain and attract moisture by design so they can be used on dry wounds without the need to add moisture. References 1. 2. 3. 4.
Burd A, Kwok CH, Hung SC, et al. A comparative study of the cytotoxicity of silverbased dressings in monolayer cell, tissue explant,and animal models. Wound Repair Regen. 2007;15:94–104. Benskin L.Activation of stalled traumatic finger wound with silver polymeric membrane dressings. Poster presentation. Symposium on Advanced Wound Care. San Antonio, Tex. April 30-May 2, 2006. Thurs K.Chronic venous ulcer closed in only seven dressing changes using silver polymeric membrane dressings. Poster presentation. Symposium on Advanced Wound Care. San Antonio, Tex. April 30-May 2, 2006. Caras J. Three malleolous wounds of two - year duration closed in four weeks using silver polymeric membrane dressings.Poster presentation. Symposium on Advanced Wound Care. San Antonio, Tex. April 30-May 2, 2006.
Pearls for Practice is made possible through the support of Ferris Mfg. Corp, B u rr Ridge, IL (www.polymem.com). The opinions and statements of the clinicians providing Pearls for Practice are specific to the respective authors and are not necessarily those of Ferris Mfg. Corp., OWM, or HMP Communications. This article was not subject to the Ostomy Wound Management peer-review process.
OstomyWound Management June 2008 Vol. 54 Issue 6